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Write prescription for following conditions below. Also, alternative medications for patients who may have allergies to...

Write prescription for following conditions below. Also, alternative medications for patients who may have allergies to Penicillin.

Allergic Rhinitis on 54 yr old with glaucoma

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Expert Solution

Treatment for allergic rhinitis (without glaucoma)

  • steroids-reduce inflammation,good for tissue growth and repair
  • antihistamines -reduce or stop allergic reaction (fexofenadine,dephenhydramine,cetrizine etc..)
  • Decongestant- releave nasal congestion and running nose(oral and topical)
  • eye decongestant-  decreases eye itching ,watery eye (antazoline phosphate)
  • anti inflammatory (montelukst ,zafirlukast )
  • bronchodilators-help to open the airway of lungs to make breath easier

These medicines can be used in patient with allergic rhinitis . But in this case the patient has Medical history of administration of medicines for glaucoma.

But

●steroids can't administer in the patient who has glaucoma. Because it will worsen the condition by increasing intraocular pressure . Chronic usage of steroid will causes optic neuropathy and development of steroid induced glaucoma.  

●antihistamines can be used safely, have no effect in open angle glaucoma (most common),people with narrow angle glaucoma may have risk of acute angle closure glaucoma.  

●Decongestant can't use patient with glaucoma

●anti inflammatory ibuprofen or acetaminophen can be used safely in this patient.  

●bronchodilators - muscarinic antagonist can't be used in this patient because it will increases intraocular pressure.  

usual alternative of penicillin

•tetracycline (doxycycline) have no side effects on eyes ,so it can be used as alternative medicine of penicillin in glaucoma patient

•quinoles (ciprofloxacin)- it will worsen the condition ,so can't be used

•amoxicillin-can be used because of lack of effect in eye

•macrolids (gentamicin)-will cause irritation of eye

prescription for allergic rhinitis patient with glaucoma

(different type of antihistamines are comparatively safe)

•amoxicillin 500 mg td for 4 days

or doxycycline (tetracycline)- alternative of penicillin

•nasal spray azelastine

• ibuprofen (anti inflammatory)

Nightingale answered 1 year ago
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